Click to edit Master title style Advocate Illinois Masonic Medical Center Digestive Health Institute A Destination Program Journey December 7, 2017 Andrew Albert, MD, MPH
2009: Background Click to edit Master title style State of GI section Click o Subsection to edit of Surgical Master Services text styles o No dedicated administrative support o No Second hospital-based level GI programs State of GI Lab The Wild West o Facilities were small o GI groups utilized the Lab as an uncoordinated workshop o Low associate/md satisfaction o No engagement o Weak section identity
Colon Cancer Awareness Month: 2011 Click to edit Master title style
2011: A Year of Change Click to edit Master title style Dedicated Leadership Click New GI to lab edit manager Master text styles New medical director New surgical director GI part of Internal Medicine Process Improvement Tackled more complex operational issues Identified wants/needs of department Asked questions (harder choice more work) Remove barriers for physicians Weekly Digestive Health Institute meetings Issues? Ideas? Growth opportunities? Identity established
With tools we can build programs Click to edit Master title style Who are our customers? What are their needs? Where do referrals come from? What should be our focus? What can we do differently? Who are our role models?
2015 Physician Road Show Click to edit Master title style Harsh reality Strong Second negative level feedback Not related to Hepatology, IBS, IBD or disease state Related to Colonoscopy Wait time >3 mos PCP burden significant Patients sent to competing system CRC Screening Rate: 17%
Significant Disconnect Click to edit Master title style Patients Frustrated Physicians struggling GI lab with low volumes Fragmentation of care System feeling leakage Measures for ACO not met
Click to edit Master title style Direct Access Screening Colonoscopy Goals: o Begin a navigated Colon Cancer Screening Experience o Reduce patient Third level colonoscopy wait time to 2-3 weeks o Increase access with stable patients, skipping the traditional face-toface consultation o Create a closed loop of communication between Digestive Health providers and referring MDs o Facilitate quality growth and efficient scheduling in the Dig. Health procedural area
Click Process to edit Map Master What title We Thought style Click Patient to enters edit Master text styles DASC* (Multiple entry points) APN communicates timeline to PCP Digestive Health APN screens patient H&P remotely APN uses a rotating list of DASC participating GIs to fairly assign patients If patient meets program criteria, APN schedules colonoscopy in 2-4 weeks APN gives prep instructions and hospital/appt. details to the patient After the procedure, the APN ensures the pathology report/next steps are communicated to PCP APN ensures the patient receives follow-up instructions/care
Click Process to edit Map Master - Realitytitle style
Click to edit Master title style Ultimately we did it! o o o o Began a navigated Colon Cancer Screening Experience Reduced patient colonoscopy wait time to 2-3 weeks Increased access with stable patients, skipping the traditional face-to-face consultation Created a closed loop of communication between Digestive Health providers and referring MDs (i.e. pathology). o o o Facilitate quality growth and efficient scheduling in the Dig. Health procedural area Achieved the ACO measure target for CRC screening among 50-65 year olds (now across the system) DASC then deployed across the entire Advocate system for Screening!
Click to edit Master title style Extrapolate to other program Additional Benefits Facilitation of care: GI CRS Oncology Cervical Cancer, Anal Cancer Closer relationship with all stakeholders Collaboration beyond Advocate with other groups FQHCs and Grants for FIT testing Social Media and outreach
Click to edit Master title style
80% CRC Screening Rates Advocate Physician Partners (PHO) AIMMC Clinical Integration Rates Click to edit Master title style 70% 69% 60% 59% 50-65 50% 44% 40% 30% 26% 30% >65 20% 17% 10% July 2014 July 2015 July 2016
Click As a result to edit Master title style 15
Click to edit Master title style 16
Click In Summary to edit Master title style Click Take a good to edit look in Master the mirrortext styles An integrated team approach is important: Transformation has challenges but work with dedicated people We must collaborate across disciplines and beyond (CRS, Anesthesia,» Fifth Oncology, level Administration) Culture change must happen to succeed The resources you need are right in front of you! We are now an entire system, covering the state of Illinois... What do you plan to accomplish in 2018?
Colon Cancer Awareness Today Click to edit Master title style
Click to edit Master title style Thank you!